Q2. What were the common characteristics of the patients who were not depressed?
Compared to patients who were not depressed, patients with depression reported poor or fair health more often (p<0.0001) and were more likely to be female (p=0.06) and HIV-infected (p=0.08).
Q3. What is the significance of the categorical likelihood ratios?
The categorical likelihood ratios also allow decision-makers to adjust the pre-test probability value for different groups of patients by taking into account factors such as medical history (e.g. HIV infection status) or laboratory data, rather than only the overall prevalence of depression in the general clinic population.
Q4. How many people with depression are unable to access mental health care?
In sub-Saharan Africa more than two-thirds of patients with severe mental illness are unable to access mental health care and this number rises to approximately 80% for patients with moderate or mild mental illness (Wang et al., 2007).
Q5. What is the main contributor to years lived with disability?
Major depressive disorder (MDD) is the second leading contributor to years lived with disability (YLD) globally, and ranks within the top four causes of YLDs in all regions worldwide (Vos et al., 2012).
Q6. What is the advantage of this approach?
The advantage to this approach is that it allowed us to evaluate the performance of screening instruments among patients who were HIV-negative as well as the 28.5% of the study population who tested HIV positive after their participation in this study.
Q7. What is the significance of the PHQ-9 in South Africa?
DISCUSSIONIn this high HIV burden PHC population in Johannesburg, South Africa, the PHQ-9 showed high accuracy in correctly classifying cases of current MDE (AUC 0.88) relative to the reference standard MINI.
Q8. What is the clinical utility of the PHQ-9 for depression screening?
When evaluating the clinical utility of the PHQ-9 for depression screening and choosing an ideal cut-off score for this setting, the authors considered the prevalence of depression in the population, the benefits and harms of screening, and the resources available for screening and follow-up.
Q9. What is the common mental disorder among HIV-infected individuals in South Africa?
MYER L, SMIT J, ROUX LL, PARKER S, STEIN DJ, SEEDAT S. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales.
Q10. What is the purpose of this study?
This study provides a framework for implementing depression screening programs in resource-scarce sub-Saharan African contexts and establishes the PHQ-9 as a useful screening instrument in these settings.
Q11. What is the effect of the PHQ-9 on the patient?
This could lead to conditional dependence through lower sensitivity of the MINI among patients who screen negative on the PHQ-9, but sensitivity analysis showed that this would only slightly affect their observed estimates of PHQ-9 performance.